Healthcare Provider Details

I. General information

NPI: 1093456998
Provider Name (Legal Business Name): ABBY LAWSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 01/22/2026
Certification Date: 01/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 NE MOTHER JOSEPH PL
VANCOUVER WA
98664-3200
US

IV. Provider business mailing address

505 NE 87TH AVE STE 210
VANCOUVER WA
98664-1988
US

V. Phone/Fax

Practice location:
  • Phone: 360-828-5396
  • Fax:
Mailing address:
  • Phone: 360-828-5396
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD70089946
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: